FR2722088A1 - Surgical implant for stabilising intervertebral spaces - Google Patents

Surgical implant for stabilising intervertebral spaces Download PDF

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FR2722088A1
FR2722088A1 FR9415290A FR9415290A FR2722088A1 FR 2722088 A1 FR2722088 A1 FR 2722088A1 FR 9415290 A FR9415290 A FR 9415290A FR 9415290 A FR9415290 A FR 9415290A FR 2722088 A1 FR2722088 A1 FR 2722088A1
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surgical implant
implant according
surgical
intervertebral
lateral
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    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/56—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
    • A61B17/58—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws, setting implements or the like
    • A61B17/68—Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
    • A61B17/70—Spinal positioners or stabilisers ; Bone stabilisers comprising fluid filler in an implant
    • A61B17/7062—Devices acting on, attached to, or simulating the effect of, vertebral processes, vertebral facets or ribs ; Tools for such devices

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  • Health & Medical Sciences (AREA)
  • Orthopedic Medicine & Surgery (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Neurology (AREA)
  • Surgery (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Engineering & Computer Science (AREA)
  • Biomedical Technology (AREA)
  • Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
  • Medical Informatics (AREA)
  • Molecular Biology (AREA)
  • Animal Behavior & Ethology (AREA)
  • General Health & Medical Sciences (AREA)
  • Public Health (AREA)
  • Veterinary Medicine (AREA)
  • Prostheses (AREA)

Abstract

The implant consists of a ring (11a,11b,11c) with a cavity (12a,12b,12c) to receive a spinal apophysis, and a lateral slot (14a,14b,14c) for engaging the apophysis with the cavity. The cavity has an arrowhead cross-section, corresponding to the shape of the apophysis, and passages in the sides for a support (20) linking a number of vertebrae and limiting intervertebral flexure. The support can be supple or rigid, and the ring can have lugs for pedicle fixing screws.

Description

IMPLANT CIIIRURGICAL DE STABILISATION DE
L'ESPACE INTERVERTEBRAL
La présente invention concerne un implant chirurgical de stabilisation de l'espace intervertébral. Elle concerne également une prothèse chirurgicale intervertébrale constituée d'une pluralité d'implants chirurgicaux selon l'invention.CIIIRURGICAL IMPLANT FOR STABILIZING
INTERVERTEBRAL SPACE
The present invention relates to a surgical implant for stabilizing the intervertebral space. It also relates to an intervertebral surgical prosthesis made up of a plurality of surgical implants according to the invention.

L'invention trouve une application avantageuse en chirurgie orthopédique, notamment lors d'affections du rachis, telles que les canaux lombaires étroits, les lyses isthmiques ou les hernies discales. The invention finds an advantageous application in orthopedic surgery, in particular during spinal disorders, such as narrow lumbar canals, isthmic lyses or herniated discs.

On connaît de l'état de la technique divers dispositifs chirurgicaux destinés à limiter le mouvement relatif des vertèbres de manière à stabiliser l'espace intervertébral dans le cas d'affections extrêmement douloureuses de la colonne vertébrale, dont la plus fréquente, la sciatique, est due à l'écrasement des nerfs rachidiens passant entre les vertèbres sous l'effet du contact mutuel dur de ces dernières au cours des mouvements de flexion ou d'extension. Various surgical devices are known from the state of the art intended to limit the relative movement of the vertebrae so as to stabilize the intervertebral space in the case of extremely painful conditions of the spine, the most frequent of which is sciatica. due to the crushing of the spinal nerves passing between the vertebrae under the effect of hard mutual contact of the latter during flexion or extension movements.

Parmi ces dispositifs connus, on peut citer des plaques ou tiges métalliques vissées qui maintiennent en permanence un écart suffisant entre les vertèbres. Toutefois, ce type de prothèses n'autorise plus les mouvements relatifs des vertèbres concernées, ce qui occasionne une gêne pénible pour les patients. De plus, l'utilisation de vis de fixation provoque des dégâts osseux très pénalisants. Enfin, ces systèmes ne donnent pas satisfaction pour le contrôle et la stabilisation de la rotation vertébrale sagitalle et frontale
D'autres dispositifs préconisent l'emploi d'un ligament souple entrelacé autour des apophyses épineuses pour réduire le débattement des vertèbres en flexion, avec intelposition de moyens de calage entre les apophyses, destinés à limiter le mouvement de rapprochement des vertèbres lors d'une extension du rachis, là où le problème de l'écrasement des nerfs rachidiens est prédominant.Among these known devices, mention may be made of screwed metal plates or rods which permanently maintain a sufficient distance between the vertebrae. However, this type of prosthesis no longer allows the relative movements of the vertebrae concerned, which causes painful discomfort for the patients. In addition, the use of fixing screws causes very damaging bone damage. Finally, these systems are not satisfactory for controlling and stabilizing the sagital and frontal vertebral rotation.
Other devices recommend the use of a flexible ligament interlaced around the spinous processes to reduce the deflection of the vertebrae in flexion, with the interposition of wedging means between the processes, intended to limit the movement of approaching the vertebrae during a extension of the spine, where the problem of crushing the spinal nerves is predominant.

Ces derniers dispositifs présentent, par rapport aux systèmes de plaques vissées, l'avantage d'une certaine souplesse, mais n'apportent aucune réponse à la question du contrôle et de la limitation de mouvement en rotation. These latter devices have the advantage of a certain flexibility over screwed plate systems, but do not provide any answer to the question of control and limitation of rotation movement.

Aussi, le problème technique à résoudre par l'objet de la présente invention est de proposer un implant chirurgical de stabilisation de l'espace intervertébral, qui permettrait, tout en préservant l'anatomie, de limiter le débattement des vertèbres lors des mouvements de flexion-extension, et à en contrôler la stabilité rotatoire sagittale et frontale. Also, the technical problem to be solved by the object of the present invention is to propose a surgical implant for stabilizing the intervertebral space, which would, while preserving the anatomy, limit the movement of the vertebrae during flexion movements. -extension, and to control the sagittal and frontal rotational stability.

La solution au problème technique posé consiste, selon la présente invention, en ce que ledit implant comprend une bague munie d'une cavité d'insertion d'une apophyse épineuse, destinée à limiter les mouvements d'extension intervertébrale. The solution to the technical problem posed consists, according to the present invention, in that said implant comprises a ring provided with an insertion cavity of a spinous process, intended to limit movements of intervertebral extension.

Ainsi, dans une prothèse chirurgicale intervertébrale constituée d'une pluralité d'implants conformes à l'invention disposés sur des apophyses épineuses consécutives, les bagues forment en quelque sorte butée les unes contre les autres lors d'une extension du rachis, ce qui réduit leur débattement et le risque d'écrasement des nerfs rachidiens au cours de ce mouvement. Thus, in an intervertebral surgical prosthesis consisting of a plurality of implants according to the invention arranged on consecutive spinous processes, the rings form in a way abutting against each other during an extension of the spine, which reduces their movement and the risk of crushing the spinal nerves during this movement.

L'invention prévoit également que ladite bague comporte des moyens de passage latéraux d'un organe de maintien d'une pluralité d'implants, destiné à limiter les mouvements de flexion intervertébrale. The invention also provides that said ring includes lateral passage means for a member for holding a plurality of implants, intended to limit the movements of intervertebral flexion.

Enfin, selon une caractéristique avantageuse de l'invention, ladite bague comporte des moyens de passage longitudinaux d'au moins un organe de rigidification d'une pluralité d'implants, destiné à limiter les mouvements de rotation intervertébrale sagitalle et frontale. Finally, according to an advantageous characteristic of the invention, said ring comprises means for longitudinal passage of at least one member for stiffening a plurality of implants, intended to limit the movements of sagital and frontal intervertebral rotation.

La description qui va suivre en regard des dessins annexés, donnés à titre d'exemples non limitatifs, fera bien comprendre en quoi consiste l'invention et comment elle peut être réalisée.  The description which follows with reference to the appended drawings, given by way of nonlimiting examples, will make it clear what the invention consists of and how it can be implemented.

La figure 1 est une vue en perspective d'un premier mode de réalisation d'un implant chirurgical de stabilisation conforme à l'invention. Figure 1 is a perspective view of a first embodiment of a stabilizing surgical implant according to the invention.

La figure 2 est une vue en perspective d'une variante d'exécution de l'implant chirurgical de la figure 1. FIG. 2 is a perspective view of an alternative embodiment of the surgical implant of FIG. 1.

La figure 3 est une vue en perspective d'un ensemble de deux implants chirurgicaux de l'invention placés sur deux vertèbres consécutives. Figure 3 is a perspective view of an assembly of two surgical implants of the invention placed on two consecutive vertebrae.

La figure 4 est une vue de dessus d'une vertèbre munie d'un implant chirurgical selon l'invention. Figure 4 is a top view of a vertebra provided with a surgical implant according to the invention.

La figure 5 est une vue en perspective d'une prothèse intervertébrale constituée de trois implants chirurgicaux conformes à l'invention. Figure 5 is a perspective view of an intervertebral prosthesis consisting of three surgical implants according to the invention.

La figure 6 est une vue en perspective d'une prothèse intervertébrale constituée de deux implants chirurgicaux et munie de moyens de rigidification. Figure 6 is a perspective view of an intervertebral prosthesis consisting of two surgical implants and provided with stiffening means.

La figure 7 est une vue de dessus d'une vertèbre munie d'un implant chirurgical portant des fentes latérales. FIG. 7 is a top view of a vertebra provided with a surgical implant carrying lateral slits.

La figure 8 est une vue de dessus d'une vertèbre munie d'un implant chirurgical portant des fentes latérales ouvertes. Figure 8 is a top view of a vertebra provided with a surgical implant carrying open side slits.

La figure 9 est une vue de dessus d'une vertèbre munie d'un implant chirurgical portant des trous longitudinaux pour tiges de rigidification. FIG. 9 is a top view of a vertebra provided with a surgical implant carrying longitudinal holes for stiffening rods.

La figure 10 est une vue de dessus d'une vertèbre munie d'un implant chirurgical portant des fentes longitudinales pour lames de rigidification. FIG. 10 is a top view of a vertebra provided with a surgical implant carrying longitudinal slots for stiffening blades.

La figure 1 1 est une vue en perspective d'un implant chirurgical de l'invention portant des oreilles latérales de fixation aux pédicules vertébraux. Figure 1 1 is a perspective view of a surgical implant of the invention carrying lateral ears for attachment to the vertebral pedicles.

La figure 12 est une vue en perspective d'un deuxième mode de réalisation d'un implant chirurgical de stabilisation conforme à l'invention. Figure 12 is a perspective view of a second embodiment of a stabilizing surgical implant according to the invention.

La figure 13 est une vue de dessus d'une prothèse intervertébrale comportant des implants chirurgicaux analogues à l'implant de la figure 12. FIG. 13 is a top view of an intervertebral prosthesis comprising surgical implants similar to the implant of FIG. 12.

La figure 14 est une vue en perspective d'une entretoise de la prothèse de la figure 13. FIG. 14 is a perspective view of a spacer of the prosthesis of FIG. 13.

La figure 15 est une vue de dessus d'une vertèbre d'un implant chirurgical portant des oreilles latérales de guidage.  FIG. 15 is a top view of a vertebra of a surgical implant carrying lateral guide ears.

Les figures 1 et 2 montrent respectivement en perspective deux implants 10, 10' chirurgicaux de stabilisation de l'espace intervertébral comprenant, chacun, une bague 11, 11' munie d'une cavité 12, 12' d'insertion d'une apophyse épineuse, ladite bague étant destinée à limiter les mouvements d'extension intervertébrale. Figures 1 and 2 show respectively in perspective two surgical implants 10, 10 'for stabilizing the intervertebral space each comprising a ring 11, 11' provided with a cavity 12, 12 'for insertion of a spinous process , said ring being intended to limit movements of intervertebral extension.

Les figures 3 et 4 illustrent la façon dont les bagues 1 la, 1 lb d'implants 10a, 10b sont engagées sur des apophyses épineuses la, lb. Figures 3 and 4 illustrate how the rings 11a, 1lb of implants 10a, 10b are engaged on spinous processes la, lb.

Naturellement, les dimensions et les formes des bagues et des cavités sont déterminées en fonction de la taille des vertèbres du tronçon rachidien à stabiliser, de façon à obtenir un maintien suffisant des implants sur les apophyses et le contact nécessaire entre deux bagues consécutives pour garantir la limitation recherchée des mouvements d'extension intervertébrale qui tendent à rapprocher les apophyses épineuses.Naturally, the dimensions and the shapes of the rings and of the cavities are determined as a function of the size of the vertebrae of the spinal section to be stabilized, so as to obtain sufficient support for the implants on the processes and the contact necessary between two consecutive rings to guarantee the sought limitation of intervertebral extension movements which tend to bring the spinous processes together.

Comme on peut le voir sur les figures 3, 5 et 6, ledit contact entre deux bagues consécutives est réalisé par l'intermédiaire d'extrémités concaves ou convexes, telles que 131, 132 et 131', 132' sur les figures 1 et 2, aménagées sur les implants, étant entendu que les extrémités en contact de deux bagues consécutives présentent des profils conjugués concave/convexe. As can be seen in Figures 3, 5 and 6, said contact between two consecutive rings is made via concave or convex ends, such as 131, 132 and 131 ', 132' in Figures 1 and 2 , fitted on the implants, it being understood that the contacting ends of two consecutive rings have concave / convex conjugate profiles.

On obtient ainsi, par emboîtement des bagues, une bonne cohérence mécanique de la prothèse chirurgicale intervertébrale lorsque celle-ci est constituée d'une pluralité d'implants montés sur plusieurs apophyses épineuses successives.There is thus obtained, by fitting the rings, good mechanical coherence of the intervertebral surgical prosthesis when it consists of a plurality of implants mounted on several successive spinous processes.

Conformément aux figures 1 et 2 en particulier, il est prévu que les bagues 11, 11' comportent une ouverture latérale 14, 14' permettant d'engager l'apophyse épineuse dans la cavité 12, 12' par insertion latérale entraînant une déformation élastique des bagues 11,11'. Cette disposition permet une mise en place latérale de l'implant 10, 10' sur le rachis, en épargnant le ligament jaune qui se trouve ainsi préservé. In accordance with FIGS. 1 and 2 in particular, provision is made for the rings 11, 11 ′ to have a lateral opening 14, 14 ′ which makes it possible to engage the spinous process in the cavity 12, 12 ′ by lateral insertion resulting in elastic deformation of the 11.11 'rings. This arrangement allows lateral placement of the implant 10, 10 'on the spine, sparing the yellow ligament which is thus preserved.

Comme le montre l'ensemble des figures, les bagues globalement référencées 11, comportent des moyens de passage latéraux d'un organe de maintien d'une pluralité d'implants, destiné à limiter les mouvements de flexion intervertébrale qui tendent à écarter les apophyses épineuses.  As shown in all the figures, the rings generally referenced 11, comprise means for lateral passage of a member for holding a plurality of implants, intended to limit the movements of intervertebral flexion which tend to spread the spinous processes .

Sur les figures 1 à 6, et 9 et 10, lesdits moyens de passage latéraux sont des passants latéraux, globalement référencés 15, disposés sur les flancs longitudinaux des bagues 11. Ces passants latéraux 15 sont destinés à recevoir un organe de maintien formé d'un ligament souple 20 artificiel ceinturant l'ensemble des implants constituant la prothèse chirurgicale intervertébrale. In FIGS. 1 to 6, and 9 and 10, said lateral passage means are lateral loops, generally referenced 15, arranged on the longitudinal sides of the rings 11. These lateral loops 15 are intended to receive a holding member formed from an artificial flexible ligament 20 surrounding all of the implants constituting the intervertebral surgical prosthesis.

Le ligament souple 20, fabriqué en Dacron (marque déposé) ou en fibres de polyéthylène par exemple, est tendu de manière à assurer la cohésion de la prothèse et à obtenir la résistance voulue aux mouvements de flexion intervertébrale. Ledit ligament 20 est refermé sur lui-même par piqûres en points de croix ou en U, ou tout autre moyen de fixation tel que boucle de ceinture. The flexible ligament 20, manufactured in Dacron (registered trademark) or in polyethylene fibers for example, is stretched so as to ensure the cohesion of the prosthesis and to obtain the desired resistance to intervertebral flexion movements. Said ligament 20 is closed on itself by stitching in cross stitches or in a U, or any other fixing means such as a belt buckle.

Les figures 7 et 8 montrent deux variantes de réalisation desdits moyens de passage latéraux. Il s'agit de fentes latérales 15' (figure 2), ou de fentes latérales 15" ouvertes latéralement (figure 8) à travers lesquelles le ligament souple de maintien formant ceinture est introduit. Figures 7 and 8 show two alternative embodiments of said lateral passage means. These are lateral slots 15 '(FIG. 2), or lateral slots 15 "open laterally (FIG. 8) through which the flexible retaining ligament forming a belt is introduced.

Comme l'indique la figure 6, des organes de rigidification d'une pluralité d'implants 10a, 10b sont prévues pour limiter les mouvements de rotation intervertébrale sagitalle et frontale. Ces organes de rigidification sont, par exemple, des lames 16 plus ou moins résistantes en polyéthylène, cobalt-chrome, titane, etc. As shown in Figure 6, stiffening members of a plurality of implants 10a, 10b are provided to limit the movements of sagital and frontal intervertebral rotation. These stiffening members are, for example, more or less resistant blades 16 made of polyethylene, cobalt-chromium, titanium, etc.

D'une manière générale, lesdits organes de rigidification sont engagés dans des moyens de passage longitudinaux qui, dans le cas de la figure 6, peuvent être les passants latéraux 15 eux-memes. Selon la première variante de la figure 9, lesdits moyens de passage longitudinaux sont des trous traversants 16', aptes à recevoir des tiges de rigidification, non représentées. In general, said stiffening members are engaged in longitudinal passage means which, in the case of FIG. 6, can be the side loops 15 themselves. According to the first variant of Figure 9, said longitudinal passage means are through holes 16 ', adapted to receive stiffening rods, not shown.

La deuxième variante de la figure 10 prévoit des fentes longitudinales 16" dans lesquelles sont insérées des lames de rigidification, non représentées.The second variant of Figure 10 provides longitudinal slots 16 "into which are inserted stiffening blades, not shown.

D'autre part, la figure 11 montre un implant 10 dont la bague 11 comporte deux oreilles latérales 17 portant chacune un trou 18 destiné à fixer ledit implant par vissage dans les pédicules vertébraux.  On the other hand, FIG. 11 shows an implant 10, the ring 11 of which comprises two lateral ears 17 each carrying a hole 18 intended to fix said implant by screwing into the vertebral pedicles.

Sur la figure 12 est représenté en perspective un autre exemple de réalisation d'un implant chirurgical 10" conforme à l'invention. Selon cet exemple, ladite bague 11" comporte une ouverture longitudinale 14" permettant l'engagement par insertion longitudinale d'une apophyse épineuse dans la cavité 12". In Figure 12 is shown in perspective another embodiment of a surgical implant 10 "according to the invention. According to this example, said ring 11" has a longitudinal opening 14 "allowing engagement by longitudinal insertion of a spinous process in the 12 "cavity.

On peut voir de manière plus précise sur la figure 12 une forme de cavité 12" particulière dont la section présente un profil en pointe de flèche, adaptée à la section correspondante de ladite apophyse épineuse. We can see more precisely in Figure 12 a particular form of cavity 12 "whose section has an arrowhead profile, adapted to the corresponding section of said spinous process.

Bien entendu, cet exemple de cavité n'est pas exclusif puisque, comme le montre la figure 13, elle peut également affecter une simple forme rectangulaire. Of course, this example of cavity is not exclusive since, as shown in Figure 13, it can also have a simple rectangular shape.

La prothèse chirurgicale intervertébrale de la figure 13 comprend une pluralité d'implants 10" à cavité rectangulaire, deux bagues 11" consécutives étant séparées par une entretoise 30 formant cale d'épaisseur. Ladite prothèse est terminée par des éléments 31 d'extrémité contre lesquels le ligament souple 20 vient en appui. The intervertebral surgical prosthesis of FIG. 13 comprises a plurality of implants 10 "with rectangular cavities, two consecutive rings 11" being separated by a spacer 30 forming a shim. Said prosthesis is terminated by end elements 31 against which the flexible ligament 20 comes to bear.

L'avantage de la prothèse de la figure 13 est de rendre la dimension des bagues 11" indépendante de l'espace intervertébral lui-même. I1 suffit donc de disposer d'un seul jeu d'implants 10" identiques, quel que soit le patient et le type des vertèbres concernées, la compensation étant effectuée à l'aide des entretoises 30 qui poulTont, par exemple, avoir trois tailles standard. Un autre avantage est qu'en peropératoire le praticien a la possibilité de choisir au dernier moment les entretoises à utiliser en fonction de ses constations. The advantage of the prosthesis of FIG. 13 is to make the dimension of the rings 11 "independent of the intervertebral space itself. It is therefore sufficient to have a single set of identical implants 10", whatever the patient and the type of vertebrae concerned, the compensation being carried out using spacers 30 which PoulTont, for example, have three standard sizes. Another advantage is that during the intraoperative period, the practitioner has the possibility of choosing at the last moment the spacers to be used according to his findings.

La figure 14 montre qu'on peut éventuellement donner à l'entretoise 30 un ou plusieurs angles a 1,ce2 d'inclinaison pour supprimer les déviations du rachis dues à une scoliose mineure ou à une syphose, par exemple. Figure 14 shows that one can optionally give the spacer 30 one or more angles a 1, ce2 of inclination to remove deviations of the spine due to minor scoliosis or syphosis, for example.

Enfin, sur la figure 15 est représentée une bague 10 comportant des oreilles latérales 17', analogues à celles de la bague de la figure 11, et munie, chacune, d'un trou longitudinal 40 de guidage destiné à recevoir une tige de guidage fixée à chaque extrémité à une vertèbre du rachis. Lesdites tiges de guidage forment main-courante pour les bagues qui peuvent de la sorte être maintenues dans une direction prédéterminée ou déterminée en peropératoire.  Finally, in Figure 15 is shown a ring 10 having lateral ears 17 ', similar to those of the ring of Figure 11, and each provided with a longitudinal guide hole 40 for receiving a fixed guide rod at each end to a vertebra of the spine. Said guide rods form a handrail for the rings which can in this way be maintained in a predetermined direction or determined intraoperatively.

Claims (19)

REVENDICATIONS 1. Implant chirurgical de stabilisation de l'espace intervertébral, caractérisé en ce que ledit implant comprend une bague munie d'une cavité d'insertion d'une apophyse épineuse, destinée à limiter les mouvements d'extension intervertébrale.1. Surgical implant for stabilizing the intervertebral space, characterized in that said implant comprises a ring provided with an insertion cavity of a spinous process, intended to limit movements of intervertebral extension. 2. Implant chirurgical selon la revendication 1, caractérisé en ce que ladite bague comporte une ouverture latérale permettant l'engagement par insertion latérale de ladite apophyse épineuse dans ladite cavité.2. A surgical implant according to claim 1, characterized in that said ring has a lateral opening allowing engagement by lateral insertion of said spinous process in said cavity. 3. Implant chirurgical selon la revendication 1, caractérisé en ce que ladite bague comporte une ouverture longitudinale permettant l'engagement par insertion longitudinale de ladite apophyse épineuse dans ladite cavité.3. Surgical implant according to claim 1, characterized in that said ring has a longitudinal opening allowing engagement by longitudinal insertion of said spinous process in said cavity. 4. Implant chirurgical selon la revendication 3, caractérisé en ce que la cavité présente une section en forme de pointe de flèche, adaptée à la section correspondante de l'apophyse épineuse.4. A surgical implant according to claim 3, characterized in that the cavity has a section in the shape of an arrowhead, adapted to the corresponding section of the spinous process. 5. Implant chirurgical selon l'une quelconque des revendications 1 à 4, caractérisé en ce que ladite bague comporte des moyens de passage latéraux d'un organe de maintien d'une pluralité d'implants, destiné à limiter les mouvements de flexion intervertébrale.5. Surgical implant according to any one of claims 1 to 4, characterized in that said ring comprises means for lateral passage of a member for holding a plurality of implants, intended to limit the movements of intervertebral flexion. 6. Implant chirurgical selon la revendication 5, caractérisé en ce que lesdits moyens de passage latéraux sont des passants latéraux.6. Surgical implant according to claim 5, characterized in that said lateral passage means are lateral loops. 7. Implant chirurgical selon l'une des revendications 5 ou 6, caractérisé en ce que ledit organe de maintien est un ligament souple.7. Surgical implant according to one of claims 5 or 6, characterized in that said holding member is a flexible ligament. 8. Implant chirurgical selon l'une quelconque des revendications 1 à 7, caractérisé en ce que ladite bague comporte des moyens de passage longitudinaux d'au moins un organe de rigidification d'une pluralité d'implants, destiné à limiter les mouvements de rotation intervertébrale sagitalle et frontale.8. Surgical implant according to any one of claims 1 to 7, characterized in that said ring comprises means for longitudinal passage of at least one member for stiffening a plurality of implants, intended to limit rotational movements sagital and frontal intervertebral. 9. Implant chirurgical selon l'une quelconque des revendications 6 à 8, caractérisé en ce que lesdits moyens de passage longitudinaux sont lesdits passants latéraux. 9. Surgical implant according to any one of claims 6 to 8, characterized in that said longitudinal passage means are said lateral loops. 10. Implant chirurgical selon la revendication 8, caractérisé en ce que lesdits moyens de passage longitudinaux sont des fentes longitudinales.10. Surgical implant according to claim 8, characterized in that said longitudinal passage means are longitudinal slots. 11. Implant chirurgical selon l'une des revendications 9 ou 10, caractérisé en ce que ledit organe de rigidification est une lame rigide.11. Surgical implant according to one of claims 9 or 10, characterized in that said stiffening member is a rigid blade. 12. Implant chirurgical selon la revendication 8, caractérisé en ce que lesdits moyens de passage longitudinaux sont des trous traversants.12. Surgical implant according to claim 8, characterized in that said longitudinal passage means are through holes. 13. Implant chirurgical selon la revendication 12, caractérisé en ce que ledit organe de rigidification est une tige rigide.13. A surgical implant according to claim 12, characterized in that said stiffening member is a rigid rod. 14. Implant chirurgical selon l'une quelconque des revendications 1 à 13, caractérisé en ce que ladite bague comporte des oreilles latérales portant un trou de fixation par vis dans les pédicules vertébraux.14. Surgical implant according to any one of claims 1 to 13, characterized in that said ring comprises lateral ears carrying a fixing hole by screw in the vertebral pedicles. 15. Implant chirurgical selon l'une quelconque des revendications 1 à 13, caractérisé en ce que ladite bague comporte des oreilles latérales portant au moins un trou longitudinal de guidage destiné à recevoir une tige de guidage fixée à une vertèbre à chacune de ses extrémités.15. Surgical implant according to any one of claims 1 to 13, characterized in that said ring comprises lateral ears carrying at least one longitudinal guide hole intended to receive a guide rod fixed to a vertebra at each of its ends. 16. Implant chirurgical selon l'une quelconque des revendications 1 à 15, caractérisé en ce que ladite bague présente au moins une extrémité concave ou convexe.16. Surgical implant according to any one of claims 1 to 15, characterized in that said ring has at least one concave or convex end. 17. Prothèse chirurgicale intervertébrale, caractérisée en ce qu'elle est constituée d'une pluralité d'implants chirurgicaux selon l'une quelconque des revendications 1 à 16, les extrémités en contact de deux bagues adjacentes présentant des profils conjugués.17. Intervertebral surgical prosthesis, characterized in that it consists of a plurality of surgical implants according to any one of claims 1 to 16, the ends in contact with two adjacent rings having conjugate profiles. 18. Prothèse chirurgicale intervertébrale, caractérisée en ce qu'elle comprend d'une pluralité d'implants chirurgicaux selon l'une des revendications 3 à 16, deux bagues adjacentes étant séparées par une entretoise formant cale d'épaisseur.18. Intervertebral surgical prosthesis, characterized in that it comprises a plurality of surgical implants according to one of claims 3 to 16, two adjacent rings being separated by a spacer forming a shim. 19. Prothèse chirurgicale intervertébrale selon la revendication 18, caractérisée en ce que ladite entretoise présente au moins un angle d'inclinaison de rattrapage de déviation du rachis. 19. Intervertebral surgical prosthesis according to claim 18, characterized in that said spacer has at least one angle of inclination to take up deviation of the spine.
FR9415290A 1994-07-08 1994-12-14 SURGICAL IMPLANT FOR STABILIZING THE INTERVERTEBRAL SPACE Expired - Fee Related FR2722088B1 (en)

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FR9408452A FR2722087A1 (en) 1994-07-08 1994-07-08 Surgical implant for limiting relative movement of vertebrae
FR9415290A FR2722088B1 (en) 1994-07-08 1994-12-14 SURGICAL IMPLANT FOR STABILIZING THE INTERVERTEBRAL SPACE

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